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Lauren Gambill, how to get cipro without prescription MDPediatrician, AustinMember, Texas Medical Association (TMA) Committee on Child and Adolescent HealthExecutive Board Member, Texas Pediatric SocietyDoctors are community leaders. This role has become even more important during the COVID-19 pandemic. As patients navigate our new reality, they are looking to us to determine how to get cipro without prescription what is safe, how to protect their families, and the future of their health care.

As more Texans lose their jobs, their health insurance, or even their homes, it is crucial that Texas receives the resources it needs to uphold our social safety net. The U.S. Census helps determine funding for those resources, and that is why it is of the upmost importance that each how to get cipro without prescription and every Texan, no matter address, immigration status, or age, respond to the 2020 U.S.

Census. The deadline has been cut short one month and now closes how to get cipro without prescription Sept. 30.COVID-19 has only increased the importance of completing the census to help our local communities and economies recover.

The novel coronavirus has inflicted unprecedented strain on patients and exacerbated inequality as more people are out of work and are many in need of help with food, health care, housing, and more. Schools also have been stretched thin, how to get cipro without prescription with teachers scrambling to teach students online. Yet, the amount of federal funding Texas has available today to help weather this emergency was driven in part by the census responses made a decade ago.

Getting an accurate count in 2020 will help Texans prepare for the decade to follow, the first few years of which most certainly will be spent rebuilding from the pandemic’s fallout. Therefore, it is vital that all how to get cipro without prescription Texans be counted.The federal dollars Texas receives generally depends on our population. A George Washington University study recently found that even a 1% undercount can lead to a $300 million loss in funding.Take Medicaid, for example.

Federal funds pay for 60% of the state’s program, which provides health coverage for two out of five Texas children, one in three individuals with disabilities, and how to get cipro without prescription 53% of all births. The complicated formula used to calculate the federal portion of this funding depends on accurate census data. If Texas’ population is undercounted, Texans may appear better off financially than they really are, resulting in Texas getting fewer federal Medicaid dollars.

If that happens, lawmakers will have to make up the difference, with cuts in services, program eligibility, or physician and provider payments, any of which are potentially detrimental.The census data also how to get cipro without prescription is key to funding other aspects of a community’s social safety net:Health careThe Children’s Health Insurance Program (CHIP) provides low-cost health insurance to children whose parents make too much to qualify for Medicaid, but not enough to afford quality coverage. Like Medicaid, how much money the federal government reimburses the state for the program depends in part on the census.Maternal and child health programs that promote public health and help ensure children are vaccinated relies on data from the census. Texas also uses this federal funding to study and respond to maternal mortality and perinatal depression.Food and housing As unemployment rises and families struggle financially, many live with uncertainty as to where they will find how to get cipro without prescription their next meal.

Already, one in seven Texans experiences food insecurity, and 20% of Texas children experience hunger. Food insecurity is rising in Texas as the pandemic continues. The Central Texas Food Bank how to get cipro without prescription saw a 206% rise in clients in March.

Funding for the Supplemental Nutrition Assistance Program and school lunch programs are both determined by the census. Funding for local housing programs also is calculated via the census. An accurate count will help ensure that how to get cipro without prescription people who lose their homes during this economic crisis have better hope of finding shelter while our communities recover.

Homelessness is closely connected with declines in overall physical and mental health.Childcare and educationAs we navigate the new reality brought on by coronavirus, more parents are taking on roles as breadwinner, parent, teacher, and caretaker. This stress how to get cipro without prescription highlights the desperate need for affordable childcare. The census determines funding for programs like Head Start that provide comprehensive early childhood education to low-income families.

The good news is you still have time to complete the census. Visit 2020census.gov to how to get cipro without prescription take it. It takes less than five minutes to complete.

Then talk to your family, neighbors, and colleagues how to get cipro without prescription about doing the same. If you are wondering who counts, the answer is everyone, whether it’s a newborn baby, child in foster care, undocumented immigrant, or an individual experiencing homelessness.Completing the census is one of the best things that you can do for the health of your community, especially during the pandemic. Thank you for helping Texas heal and for supporting these essential safety net programs.(L to R).

UTHSA medical students Swetha Maddipudi, how to get cipro without prescription Brittany Hansen, Charles Wang, Carson Cortino, faculty advisor Kaparaboyna Kumar, MD, Ryan Wealther, Sidney Akabogu, Irma Ruiz, and Frank Jung pose with the TMA Be Wise Immunize banner. Photo courtesy by Ryan WealtherRyan WealtherMedical Student, UT Health San Antonio Long School of MedicineStudent Member, Texas Medical AssociationEditor’s Note. August is National Immunization Awareness Month.

This article is part of a Me&My Doctor series highlighting and promoting the use how to get cipro without prescription of vaccinations.“Can the flu shot give you the flu?. €â€œIs it dangerous for pregnant women to get a flu shot?. €â€œCan vaccines how to get cipro without prescription cause autism?.

€These were questions women at Alpha Home, a residential substance abuse rehabilitation center in San Antonio, asked my fellow medical students and me during a flu vaccine discussion. It is easy to see why these questions were asked, as vaccine misinformation is common today.UTHSA medical student Frank Jing (left) gets a vaccine fromKaparaboyna Kumar, MD, (right).Photo courtesy of Ryan Wealther“No” is the answer to all the questions. These were exactly the types of myths we set out to dispel at our vaccination drive.UT Health San Antonio Long School of Medicine medical students (under the supervision of Kaparaboyna Ashok Kumar, MD, faculty advisor for the Texas Medical Association Medical Student Section at UT Health San Antonio) hosted the vaccine drive at Alpha Home with how to get cipro without prescription the support of TMA’s Be Wise – Immunize℠ program, a public health initiative that aims to increase vaccinations and vaccine awareness through shot clinics and education.

Our program consisted of a vaccination drive and an interactive, educational presentation that addressed influenza, common flu shot questions, and general vaccine myths. The Alpha Home residents could ask us questions during the program.We were interested to see if our educational how to get cipro without prescription program could answer Alpha Home residents’ questions about vaccinations and allay their hesitations about getting a flu vaccination. To gauge this, we created a brief survey.(Before I discuss the results of the survey, I should define vaccine hesitancy.

Vaccine hesitancy is a concept defined by the World Health Organization. It relates how to get cipro without prescription to when patients do not vaccinate despite having access to vaccines. Vaccine hesitancy is a problem because it prevents individuals from receiving their vaccinations.

That makes them more susceptible to getting sick from vaccine-preventable diseases.)We surveyed the residents’ opinions about vaccinations before and after our educational program. While opinions about shots improved with each survey question, we saw the most significant attitude change reflected in answers to the questions “I am how to get cipro without prescription concerned that vaccinations might not be safe,” and “How likely are you to receive a flu shot today?. € We had informed the residents and improved their understanding and acceptance of immunizations.Post-survey results show more residents at the Alpha Home shifted to more positive attitudes about vaccines, after learning more about their effectiveness by trusted members of the medical community.

Graph by how to get cipro without prescription Ryan WealtherWhy is this important?. First, our findings confirm what we already knew. Education by a trusted member of the medical community can effect change.

In fact, it is widely known that physician recommendation of vaccination is one of the most critical factors affecting whether patients receive an influenza vaccination how to get cipro without prescription. Perhaps some added proof to this is that a few of the Alpha Home residents were calling me “Dr. Truth” by the end of the evening.Second, our findings add to our understanding of adult vaccine hesitancy how to get cipro without prescription.

This is significant because most of what we know about vaccine hesitancy is limited to parental attitudes toward their children’s vaccinations. Some parents question shots for their children, and many of the most deadly diseases we vaccinate against are given in childhood, including polio, tetanus, measles, and whooping cough shots. However, adults need some vaccinations as well, like the how to get cipro without prescription yearly influenza vaccine.

After taking part in the UTHSA educational program, more residents at the Alpha Home shared more willingness to receive the flu vaccine. Graph by Ryan WealtherAnother reason improving attitudes is important is that receiving a flu shot is even more timely during the COVID-19 pandemic because it decreases illnesses and conserves health care resources. Thousands of people each year are hospitalized from the flu, and with hospitals filling up with coronavirus patients, we how to get cipro without prescription could avoid adding dangerously ill flu patients to the mix.

Lastly, these findings are important because once a COVID-19 vaccination becomes available, more people might be willing to receive it if their overall attitude toward immunizations is positive. Though the COVID-19 vaccine is how to get cipro without prescription still in development, it is not immune to vaccine hesitancy. Recent polls have indicated up to one-third of Americans would not receive a COVID-19 vaccine even if it were accessible and affordable.

Work is already being done to try to raise awareness and acceptance. In addition, misinformation about the COVID vaccine is circulating how to get cipro without prescription widely. (Someone recently asked me if the COVID vaccine will implant a microchip in people, and I have seen the same myth circulating on social media.

It will not.) This myth, however, illustrates the need for health care professionals to answer patients’ questions and to assuage their concerns.Vaccines work best when many people in a community receive them, and vaccine hesitancy how to get cipro without prescription can diminish vaccination rates, leaving people who can't get certain vaccines susceptible to these vaccine-preventable diseases. For example, babies under 6 months of age should not receive a flu shot, so high community vaccination rates protect these babies from getting sick with the flu. Our educational program at Alpha Home is just one example of how health care professionals can increase awareness and acceptance of shots.

As the COVID-19 pandemic how to get cipro without prescription progresses, we need to ensure children and adults receive their vaccinations as recommended by their physician and the Centers for Disease Control and Prevention. I encourage readers who have questions about the vaccinations they or their child may need to talk with their physician. As health care professionals, we’re more than happy to answer your questions..

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Throughout the COVID-19 pandemic, InnovaCare Health, which operates Medicare Advantage and Medicaid plans in Puerto Rico—as well as in Florida—has been working closely with providers and government leaders to address the virus’ spread, including doing home delivery of everything from cipro tendon rupture incidence medicines to food for useful link its members in the territory. CEO Dr. Richard Shinto spoke with Modern Healthcare Managing cipro tendon rupture incidence Editor Matthew Weinstock. The following is an edited transcript.MH. What’s the state of play in Puerto Rico right now?.

Shinto. I think the government did a very good job during the first few months of the pandemic. They closed down the island. No ships were allowed to come in. Tourism was stopped.

The reason they did that was they don’t have a deep enough healthcare system to have ventilators and all the necessary means to protect all the residents of the island.So the governor mandated across-the-board curfews and shut everything down. They did a very good job of really suppressing the infection.Our numbers are very low. I think maybe we broke close to 400 deaths total. There’s maybe 24,000 positive cases right now. The last numbers I saw, (there were) about 400 people in the hospital.

Really, that’s more of a (recent) surge. It was even lower than that, but when everything started to open up, especially bars, all of a sudden there was another surge.Currently, the stay-at-home policy is a curfew from 10 at night until five in the morning. No alcohol (sold) after 7 p.m. On Sundays, everybody has to stay indoors unless it’s just for grocery shopping or going to the pharmacy. Again, the government is putting a lot of pressure on everybody and the difference between Puerto Rico and a lot of other places (in the U.S.), they actually do implement it and they actually do fine you.

The fines can be up to $500 if you’re not wearing a mask and you wander around the streets in Puerto Rico.MH. Can you talk about your experience working with the government in Puerto Rico versus in Florida?. Shinto. One of the things Puerto Rico has done a very good job of is creating alignment. There’s alignment between the health plans, the providers, the hospitals and the government.

So when we go to D.C. Or we speak on behalf of the island, it’s usually one voice.MH. Working with providers, you advanced payments to doctors and hospitals in the early stages of the pandemic. That’s continuing, right?. €¨Shinto.

Yes. To date we’ve paid out somewhere over $160 million of advance payments to providers, both hospitals and physicians. Many of our specialists are on fee-for-service, so we did quick calculations on what our average pay to them was. From that, we were able to advance pay them.It’s interesting about disasters and the number of them that hit the island. We learned this after Hurricane Maria—the physicians needed the income and they’re not going to be able to submit encounter data.On the pandemic, we advance paid the doctors before we shut down the offices.

We knew they needed income so they could continue to take care of the beneficiaries and members.MH. Can you talk about the work you’re doing with at-home delivery of medications and over-the-counter supplies?. Shinto. As you practice in the States, you think about mail order and you think about chain pharmacies. That doesn’t really work here.

So over the years, we got into home delivery. We do home delivery for almost everything—your pharmacy, all your over-the-counter (supplies). Even prior to the pandemic, we were already starting home delivery of food.Puerto Rico is a great testing ground. When people started to get all their medications, all their (personal protective equipment)—if they wanted masks or they needed antiseptics for their hands—they just (place an order) on the website and it gets delivered within 48 hours. Then we started delivering food and then people didn’t want it pre-cooked.

They wanted to make their own. Then we started offering groceries, so you can go onto our sites and get whatever you need.We’ve built it into our benefit design so that members can get an iPhone, because then the app is already loaded—allowing them to order all their over-the-counter (supplies) or if it’s connected into the pharmacy, they can get home delivery there as well. We believe the future of healthcare has to be in that space of delivery.MH. What challenges have you had, if any, building up a supply chain?. Shinto.

One thing we learned after (natural) disasters is you’ve got to be ahead of the supply chain. I remember all the water we had ordered after (Hurricane Maria) and the generators, but FEMA came in and took control and it bothered us that we had a great supply chain. We had pre-ordered a http://cz.keimfarben.de/how-can-i-buy-cipro/ lot, but then the (U.S.) government comes and takes over.When COVID came, we again preplanned and we went to the supply chain. We were able to move 3,500 employees out of the offices, into their homes, in less than a week. We had a lot of supplies like computers and modems for people who needed it.

We did a great job on pre-ordering PPE and COVID testing. But again, the (U.S.) government came in and confiscated everything. Then, we had to struggle to get the masks, or we had to go to China. So that created some problems. Even today, because of the limited amount of reagent on the island, the Puerto Rican government has taken control of testing.MH.

So PPE was taken from the island and brought back to the mainland?. Shinto. It wasn’t allowed to ship to the island. Even the COVID testing, which we had pre-bought. Being a physician and thinking about looking ahead … we needed to have, masks, gowns and gloves.

We went after those and then the testing and we were able to buy a lot of testing, but then they would get stopped at the ports. The government would take over in the States and then redirect it someplace else.Our country is now more than six months into the worst public health crisis we have known in over a century. More than 6 million confirmed COVID-19 cases and 190,000-plus documented fatalities later, what have we learned?. Truth is, we have acquired an enormous amount of actionable knowledge about the virus—how to test for and better treat it, how to prevent its spread and how to protect ourselves against it. But gaining knowledge and applying it successfully are not the same thing.

Large health systems are in a unique position to share some broad core lessons that can serve us all well going forward. Take care of our healthcare heroes. Even our doctors and nurses who served in the military or trained in emergency medicine never imagined having to put their own lives and livelihoods on hold for such extended periods. Even after the pandemic has passed, thousands of them may experience a unique form of professional and personal post-traumatic stress disorder. We must recognize and address this by rotating them off the front lines and expanding the healthcare workforce.

Recognize that disparities are a matter of life and death. Health disparities grounded in race and ethnicity have been subject to policy discussions for decades. The disadvantaged face a perfect storm. More likely to be exposed to the virus, but less likely to have access to testing and treatment. More likely to have underlying conditions, but less likely to cope with the financial impacts of the pandemic.

And perhaps soon—less likely to be able to access the vaccines that afford some level of protection. Here comes the flu … It is always important for everyone, most certainly caregivers, to get a flu vaccination. But this year individuals must be accountable for their symptoms like never before. Stay home if you are sick and call your doctor right away if you have symptoms (telehealth calls are easier and more available than ever). Remember.

Flu symptoms and COVID-19 symptoms can be very similar. €¦ and sometime soon, a COVID-19 vaccine. Our nation’s handling of the pandemic to date must not presage our handling of a vaccine. The approval process must be science-driven and inspire public confidence. Distribution must initially prioritize essential workers.

As more widespread vaccinations are possible, no one should have to go without due to access or affordability challenges. End the “mask confusion.” As a nation, it took many years and multimillion-dollar public-awareness campaigns for us to wear seat belts and stop smoking in public places. Those were long-term appeals, but we do not have the luxury of time right now. The science has evolved, and there’s more evidence than ever before that wearing a mask is effective. In fact, wearing a mask must be a universally accepted norm.Quick, reliable testing.

We cannot afford an on-again, off-again commitment to COVID-19 testing. For the foreseeable future, it is an imperative. But real challenges remain. While identifying positive cases has obvious benefits, waiting five to 10 days for results almost nullifies the capacity to contain spread. We need a consistent focus on deploying convenient tests that produce reliable, rapid results and actively driving their use, particularly among high-risk populations, in hot spots and for those exposed to a known positive.Prepare to be screened.

For the foreseeable future, and perhaps indefinitely, screening in healthcare facilities and other public venues will be the new normal. When you come to a hospital or clinic, expect to have your temperature taken and answer screening questions. These are for everyone’s safety—patients and caregivers.No healthcare professional needs to be reminded of the seriousness of what lies ahead. Let’s take what we’ve learned, be ready and willing to adapt—and build a new resolve to defeat this virus together..

Throughout the COVID-19 pandemic, InnovaCare Health, which operates Medicare Advantage and Medicaid plans in Puerto Rico—as well as how to get cipro without prescription in Florida—has been working closely with providers and government leaders to address the virus’ spread, including doing home http://cz.keimfarben.de/can-you-buy-cipro-without-a-prescription/ delivery of everything from medicines to food for its members in the territory. CEO Dr. Richard Shinto spoke how to get cipro without prescription with Modern Healthcare Managing Editor Matthew Weinstock. The following is an edited transcript.MH.

What’s the state of play in Puerto Rico right now?. Shinto. I think the government did a very good job during the first few months of the pandemic. They closed down the island.

No ships were allowed to come in. Tourism was stopped. The reason they did that was they don’t have a deep enough healthcare system to have ventilators and all the necessary means to protect all the residents of the island.So the governor mandated across-the-board curfews and shut everything down. They did a very good job of really suppressing the infection.Our numbers are very low.

I think maybe we broke close to 400 deaths total. There’s maybe 24,000 positive cases right now. The last numbers I saw, (there were) about 400 people in the hospital. Really, that’s more of a (recent) surge.

It was even lower than that, but when everything started to open up, especially bars, all of a sudden there was another surge.Currently, the stay-at-home policy is a curfew from 10 at night until five in the morning. No alcohol (sold) after 7 p.m. On Sundays, everybody has to stay indoors unless it’s just for grocery shopping or going to the pharmacy. Again, the government is putting a lot of pressure on everybody and the difference between Puerto Rico and a lot of other places (in the U.S.), they actually do implement it and they actually do fine you.

The fines can be up to $500 if you’re not wearing a mask and you wander around the streets in Puerto Rico.MH. Can you talk about your experience working with the government in Puerto Rico versus in Florida?. Shinto. One of the things Puerto Rico has done a very good job of is creating alignment.

There’s alignment between the health plans, the providers, the hospitals and the government. So when we go to D.C. Or we speak on behalf of the island, it’s usually one voice.MH. Working with providers, you advanced payments to doctors and hospitals in the early stages of the pandemic.

That’s continuing, right?. €¨Shinto. Yes. To date we’ve paid out somewhere over $160 million of advance payments to providers, both hospitals and physicians.

Many of our specialists are on fee-for-service, so we did quick calculations on what our average pay to them was. From that, we were able to advance pay them.It’s interesting about disasters and the number of them that hit the island. We learned this after Hurricane Maria—the physicians needed the income and they’re not going to be able to submit encounter data.On the pandemic, we advance paid the doctors before we shut down the offices. We knew they needed income so they could continue to take care of the beneficiaries and members.MH.

Can you talk about the work you’re doing with at-home delivery of medications and over-the-counter supplies?. Shinto. As you practice in the States, you think about mail order and you think about chain pharmacies. That doesn’t really work here.

So over the years, we got into home delivery. We do home delivery for almost everything—your pharmacy, all your over-the-counter (supplies). Even prior to the pandemic, we were already starting home delivery of food.Puerto Rico is a great testing ground. When people started to get all their medications, all their (personal protective equipment)—if they wanted masks or they needed antiseptics for their hands—they just (place an order) on the website and it gets delivered within 48 hours.

Then we started delivering food and then people didn’t want it pre-cooked. They wanted to make their own. Then we started offering groceries, so you can go onto our sites and get whatever you need.We’ve built it into our benefit design so that members can get an iPhone, because then the app is already loaded—allowing them to order all their over-the-counter (supplies) or if it’s connected into the pharmacy, they can get home delivery there as well. We believe the future of healthcare has to be in that space of delivery.MH.

What challenges have you had, if any, building up a supply chain?. Shinto. One thing we learned after (natural) disasters is you’ve got to be ahead of the supply chain. I remember all the water we had ordered after (Hurricane Maria) and the generators, but FEMA came in and took control and it bothered us that we had a great supply chain.

We had http://cz.keimfarben.de/how-to-get-cipro-without-prescription/ pre-ordered a lot, but then the (U.S.) government comes and takes over.When COVID came, we again preplanned and we went to the supply chain. We were able to move 3,500 employees out of the offices, into their homes, in less than a week. We had a lot of supplies like computers and modems for people who needed it. We did a great job on pre-ordering PPE and COVID testing.

But again, the (U.S.) government came in and confiscated everything. Then, we had to struggle to get the masks, or we had to go to China. So that created some problems. Even today, because of the limited amount of reagent on the island, the Puerto Rican government has taken control of testing.MH.

So PPE was taken from the island and brought back to the mainland?. Shinto. It wasn’t allowed to ship to the island. Even the COVID testing, which we had pre-bought.

Being a physician and thinking about looking ahead … we needed to have, masks, gowns and gloves. We went after those and then the testing and we were able to buy a lot of testing, but then they would get stopped at the ports. The government would take over in the States and then redirect it someplace else.Our country is now more than six months into the worst public health crisis we have known in over a century. More than 6 million confirmed COVID-19 cases and 190,000-plus documented fatalities later, what have we learned?.

Truth is, we have acquired an enormous amount of actionable knowledge about the virus—how to test for and better treat it, how to prevent its spread and how to protect ourselves against it. But gaining knowledge and applying it successfully are not the same thing. Large health systems are in a unique position to share some broad core lessons that can serve us all well going forward. Take care of our healthcare heroes.

Even our doctors and nurses who served in the military or trained in emergency medicine never imagined having to put their own lives and livelihoods on hold for such extended periods. Even after the pandemic has passed, thousands of them may experience a unique form of professional and personal post-traumatic stress disorder. We must recognize and address this by rotating them off the front lines and expanding the healthcare workforce. Recognize that disparities are a matter of life and death.

Health disparities grounded in race and ethnicity have been subject to policy discussions for decades. The disadvantaged face a perfect storm. More likely to be exposed to the virus, but less likely to have access to testing and treatment. More likely to have underlying conditions, but less likely to cope with the financial impacts of the pandemic.

And perhaps soon—less likely to be able to access the vaccines that afford some level of protection. Here comes the flu … It is always important for everyone, most certainly caregivers, to get a flu vaccination. But this year individuals must be accountable for their symptoms like never before. Stay home if you are sick and call your doctor right away if you have symptoms (telehealth calls are easier and more available than ever).

Remember. Flu symptoms and COVID-19 symptoms can be very similar. €¦ and sometime soon, a COVID-19 vaccine. Our nation’s handling of the pandemic to date must not presage our handling of a vaccine.

The approval process must be science-driven and inspire public confidence. Distribution must initially prioritize essential workers. As more widespread vaccinations are possible, no one should have to go without due to access or affordability challenges. End the “mask confusion.” As a nation, it took many years and multimillion-dollar public-awareness campaigns for us to wear seat belts and stop smoking in public places.

Those were long-term appeals, but we do not have the luxury of time right now. The science has evolved, and there’s more evidence than ever before that wearing a mask is effective. In fact, wearing a mask must be a universally accepted norm.Quick, reliable testing. We cannot afford an on-again, off-again commitment to COVID-19 testing.

For the foreseeable future, it is an imperative. But real challenges remain. While identifying positive cases has obvious benefits, waiting five to 10 days for results almost nullifies the capacity to contain spread. We need a consistent focus on deploying convenient tests that produce reliable, rapid results and actively driving their use, particularly among high-risk populations, in hot spots and for those exposed to a known positive.Prepare to be screened.

For the foreseeable future, and perhaps indefinitely, screening in healthcare facilities and other public venues will be the new normal. When you come to a hospital or clinic, expect to have your temperature taken and answer screening questions. These are for everyone’s safety—patients and caregivers.No healthcare professional needs to be reminded of the seriousness of what lies ahead. Let’s take what we’ve learned, be ready and willing to adapt—and build a new resolve to defeat this virus together..

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Side effects that you should report to your doctor or health care professional as soon as possible:

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

This list may not describe all possible side effects.

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A central part of the role will be to lead basic best place to buy cipro online physics and radiation protection modules delivered to all students within the group.You will have experience in medical imaging/nuclear medicine from work in a variety of clinical settings. Previous experience in a teaching and/or academic management role is desirable. A qualification related to teaching in Higher Education best place to buy cipro online is also essential for this role. However, this could be obtained once the role commences.You will be mainly based at the Lancaster campus, though you will occasionally be required to travel to other best place to buy cipro online locations to deliver courses or clinical education support.

Individuals with an innovative approach to developing distance learning materials for students studying medical physics topics would be especially welcome to apply.You will benefit from a generous annual leave allowance, the ability to manage your own diary and work with a high degree of autonomy as well as joining a small, friendly team. Extensive personal development opportunities will be available.Informal best place to buy cipro online enquiries. Charles Sloane, charles.sloane@cumbria.ac.uk or 07714 107655Expected interview date. Monday 23rd November 2020For more information about the University of Cumbria including the comprehensive staff benefits please click https://www.cumbria.ac.uk/about/job-vacancies/We particularly welcome Male and BAME applicants who are under-represented in this staff group..

Old Road Campus Research top article Building, Headington, Oxford, OX3 how to get cipro without prescription 7DQGrade 10. £55,750 - £64,605 per annum (with discretionary scale to £70,579)We have an opportunity for a new Group Leader, who will how to get cipro without prescription report to the Director of the Oxford Institute of Radiation Oncology. The postholder will be head of a significant research group focused on how radiation affects the immune response of tumours and will how to get cipro without prescription develop research questions and have the skills necessary to design and progress these questions in the laboratory, moving into clinical applications in due course and with collaborators, potentially translating them into clinical trials.The post holder will initiate and implement a long-term interdisciplinary research programme in the area of adaptive and immune biology and in combination with radiation therapy.

They will also manage substantial research resources and budgets, generate research income and actively promote the research area and participate in the training and supervision of post-doctoral trainees, graduate students and junior scientists in the department.The post holder will be a recognised authority in their field and head a significant research group. The post holder will be expected to develop their own independent, innovative research programme, and will have responsibility for the development of its strategic direction, how to get cipro without prescription working in collaboration with both basic and translational groups in Oxford.The post holder will hold a relevant PhD/DPhil with significant post-qualification research experience and will have an established international publication record, as well as experience of managing research projects and staff. Specific expertise in translational research would be advantageous.This is a full time fixed term post until 31 March how to get cipro without prescription 2022 in the first instance.All applicants must complete an application form and upload a CV and supporting statement.Informal enquiries can be made to Dr Toni Fleming toni.fleming@oncology.ox.ac.ukThe closing date for applications is 12.00 noon on 30 October 2020.https://my.corehr.com/pls/uoxrecruit/erq_jobspec_version_4.jobspec?.

P_id=147212The multi-award winning University of Cumbria is a wonderful blend of old and new, founded on a rich educational history with institutions dating back more than 150 years.Now is a very exciting time to be joining us because we are delivering a new strategic plan focused on making the most of our three most valuable assets. People, Place and Partnerships, to become a catalyst for economic well-being for our how to get cipro without prescription region, nationally and internationally.Working in partnership with local NHS trusts, health and social care providers, service users and carers. Our Institute of Health how to get cipro without prescription provides initial pre-registration education for a broad range of health care professionals, including occupational therapy, diagnostic radiography, sports rehabilitation and coaching, midwifery, physiotherapy, social work, children and families, psychology, paramedic, counselling, all four fields of nursing, assistant practitioner and nursing associate.

Our well established portfolio of continuing professional development is key to workforce development and upskilling of staff who are employed within the sector. Our aim is to support the skills requirements of the region, by attracting and retaining health professionals who will provide high quality, evidence-based care in a time of change in health how long to take cipro for diverticulitis and how to get cipro without prescription social care. The Institute of Health is happy to consider flexible employment opportunities, including job share and secondments.The Medical Sciences Team are welcoming applications from enthusiastic and self-motivated individuals to take a how to get cipro without prescription leading role in running Healthcare Science/Medical Physics Technology courses run within Medical Sciences.

A central part of the role will be to lead basic physics and radiation protection modules delivered to all students within the group.You will have experience in medical imaging/nuclear medicine how to get cipro without prescription from work in a variety of clinical settings. Previous experience in a teaching and/or academic management role is desirable. A qualification related to teaching in Higher Education how to get cipro without prescription is also essential for this role.

However, this could be obtained once the role commences.You will be mainly based at the Lancaster campus, though how to get cipro without prescription you will occasionally be required to travel to other locations to deliver courses or clinical education support. Individuals with an innovative approach to developing distance learning materials for students studying medical physics topics would be especially welcome to apply.You will benefit from a generous annual leave allowance, the ability to manage your own diary and work with a high degree of autonomy as well as joining a small, friendly team. Extensive personal development how to get cipro without prescription opportunities will be available.Informal enquiries.

Charles Sloane, charles.sloane@cumbria.ac.uk or 07714 107655Expected interview how to get cipro without prescription date. Monday 23rd November 2020For more information about the University of Cumbria including the comprehensive staff benefits please click https://www.cumbria.ac.uk/about/job-vacancies/We particularly welcome Male and BAME applicants who are under-represented in this staff group..

Flagyl and cipro for c diff

NONE

October is flagyl and cipro for c diff Mental Health Awareness Month and World Mental Health Day takes place on 10 October 2020. This year, the COVID-19 pandemic has added a new dimension to concerns regarding mental health in our communities. Across the globe stories continue to emerge of people’s experiences of anxiety, fear and depression due to the uncertainty and stress brought on by the virus.1–3 Job losses, financial and housing insecurity, the challenges of working from home, flagyl and cipro for c diff home schooling, restricted access to health and social care services and social isolation coupled with reduced support and contact with family and friends have all impacted people’s well-being. There is particular concern about the mental health of healthcare workers during this difficult time.While most healthcare workers are resilient to the long-term effects of this period of stress and anxiety, there is the added worry about scarce resources, lack of cure or effective treatment options, isolation from family, coping with patient suffering and deaths and the moral and ethical impact of decisions as to who will receive acute care.

These factors have significant potential for negative repercussions on the mental health and well-being of healthcare flagyl and cipro for c diff staff.4 5 There have been reports of high levels of stress, depression and even suicides,6 and long-term effects include a higher risk for post-traumatic stress disorder or moral injury.5Healthcare organisations need to plan for the inevitable consequence of this pandemic and ensure that resources are in place for their workers. Screening for mental health issues and treatment, including counselling, should be made available. In addition, nurses and other healthcare staff should be encouraged to reflect flagyl and cipro for c diff on their experiences and consider how to implement self-care strategies that will enhance their well-being. This includes staying informed of the current data and information and being aware of the risks to themselves and others while caring for patients with the virus.

By monitoring and enacting strategies to reduce stress and develop support systems, staff can minimise longer-term impacts.4Whether organisational support and self-care monitoring have achieved better mental health outcomes for healthcare workers is, as yet, unknown. Research across the globe is underway not only related to the virus itself but also to the mental health consequences of flagyl and cipro for c diff the pandemic. We do not yet know the extent of the issues or how best to support healthcare providers. In order to better understand flagyl and cipro for c diff the issues and to support nurses at this time, evidence-based nursing will focus our social media to mental health issues during the month of October.

We will highlight and share relevant resources and information and encourage discussion of the key challenges facing healthcare workers.During October, we will showcase the experiences of four key groups—patients, nurses, students and informal carers and families. Be sure to log into evidence-based nursing flagyl and cipro for c diff each week for the following blogs:October 4. Impact of COVID-19 on patient mental health.October 11. Impact of COVID-19 on nurses’ mental health and.Twitter Chat on Wednesday October 14 at flagyl and cipro for c diff 20:00 UK time.Oct.

18. Impact of COVID-19 on student nursing.Oct. 25. Impact of COVID-19 on informal carers and families.A PhD is a globally recognised postgraduate degree and typically the highest degree programme awarded by a University, with students usually required to expand the boundaries of knowledge by undertaking original research.

The purpose of PhD programmes of study is to nurture, support and facilitate doctoral students to undertake independent research to expected academic and research standards, culminating in a substantial thesis and examined by viva voce. In this paper—the first of two linked Research Made Simple articles—we explore what the foundations of a high-quality PhD are, and how a Doctoral candidate can develop a study which is successful, original and impactful.Foundations of a ‘good’ PhD studySupervision and supportCentral to the development and completion of a good PhD is the supervisory relationship between the student and supervisor. The supervisor guides the student by directing them to resources and training to ensure continuous learning, provides opportunity to engage with experts in the field, and facilitates the development of critical thinking through questioning and providing constructive criticism.1The support needs of students will be different, so a flexible yet quality assured approach to PhD research training is required. A good supervisory team (usually includes at least two postdoctoral academics) provide experienced guidance and mentorship and will offer students academic support, with regular meetings and timely feedback on written submissions, will assist the student to develop a peer network and help them access research communities relative to their field.

Effective supervision has beneficial outcomes for students, including encouraging a positive work ethic and influencing engagement in a stimulating environment, allowing students to pursue their own ideas with educated encouragement. The quality of the supervisory relationship can impact greatly on the PhD experience and ultimately sets the student on the road to producing excellent Doctoral work.1An environment that promotes personal and professional development is further aided by positive peer interactions. If students feel part of a community and have contact with others also working on doctoral studies, there is the scope for peer compassion and understanding during both challenging and rewarding periods. Students who access personal and professional support and guidance through mentoring models during their studies are more likely to succeed.

These models include one-to-one peer mentoring or activities for example journal discussion or methods learning groups. Often, groups of students naturally come together and give each other support and advice about research process expectations and challenges, and offer friendship, and guidance.2 Given the usefulness of different types of mentoring models, all can create a supportive and collaborative environment within a PhD programme of study, to minimise working in isolation and enable students to achieve their greatest potential.Characteristics of a good study. Originality and theoretical underpinningA PhD should make an original contribution to knowledge. Originality can be achieved through the study design, the nature or outcomes of the knowledge synthesis, or the implications for research and/or practice.3 Disciplinary variation, however, influences the assessment of originality.

For example, originality in science, technology, engineering and mathematics subjects is often inferred if the work is published/publishable, in comparison to intellectual originality in the social sciences.4 Although PhD originality assumes different nuances in different contexts, there is a general acceptance across disciplines that there should be evidence of the following within the thesis:An interplay between old and new—any claims of originality are developed from existing knowledge and practices.There are degrees of originality, relating to more than one aspect of the thesis.Any claims for originality are accompanied by clear articulation of significance.A good PhD should be also underpinned by theoretical and/or conceptual frameworks (that include philosophical and methodological models) that give clarity to the approach, structure and vision of the study.5 These theoretical and conceptual frameworks can explain why the study is pertinent and how the research addresses gaps in the literature.6 Table 1 provides a distinction of what construes theoretical and conceptual frameworks.View this table:Table 1 Characteristics of theoretical and conceptual frameworks7Theoretical/conceptual frameworks must align with the research question/aims, and the student must be able to articulate how conceptual/theoretical framework were chosen. Key points for consideration include:Are the research questions/aim and objectives well defined?. What theory/theories/concepts are being operationalised?. How are the theories/concepts related?.

Are the ontological and epistemological perspectives clearly conveyed and how do they relate to theories and concepts outlined?. What are the potential benefits and limitations of the theories and concepts outlined?. Are the ways the theories/concepts are outlined and being used original?. A PhD thesis (and demonstrable in viva) must be able to offer cohesion between the choice of research methods that stems from the conceptual/theoretical framework, the related ontological and epistemological decisions, the theoretical perspective and the chosen methodology (table 2).

PhD students must be able to articulate the methodological decisions made and be critical of methods employed to answer their research questions.View this table:Table 2 Relationship between research paradigms, perspectives, methodologies and methods.8 9ConclusionIn summary, we offer considerations of what the foundations of a good PhD should be. We have considered some of the key ingredients of quality PhD supervision, support and research processes and explored how these will contribute to the development of a study that leads to student success and which makes a valuable contribution to the evidence base. In the next paper, we will look in more detail at the assessment of the PhD through the submission of a thesis and an oral viva..

October is Mental Health Awareness how to get cipro without prescription Month and World Mental Health Day takes place on 10 October 2020. This year, the COVID-19 pandemic has added a new dimension to concerns regarding mental health in our communities. Across the globe stories continue to emerge of people’s experiences of anxiety, fear and depression due to the uncertainty and stress brought on by the virus.1–3 Job losses, financial and housing insecurity, the challenges of working from home, home schooling, restricted access to health and social care how to get cipro without prescription services and social isolation coupled with reduced support and contact with family and friends have all impacted people’s well-being.

There is particular concern about the mental health of healthcare workers during this difficult time.While most healthcare workers are resilient to the long-term effects of this period of stress and anxiety, there is the added worry about scarce resources, lack of cure or effective treatment options, isolation from family, coping with patient suffering and deaths and the moral and ethical impact of decisions as to who will receive acute care. These factors have significant potential for negative repercussions on the mental health how to get cipro without prescription and well-being of healthcare staff.4 5 There have been reports of high levels of stress, depression and even suicides,6 and long-term effects include a higher risk for post-traumatic stress disorder or moral injury.5Healthcare organisations need to plan for the inevitable consequence of this pandemic and ensure that resources are in place for their workers. Screening for mental health issues and treatment, including counselling, should be made available.

In addition, nurses and other healthcare staff should be encouraged to reflect on their experiences and how to get cipro without prescription consider how to implement self-care strategies that will enhance their well-being. This includes staying informed of the current data and information and being aware of the risks to themselves and others while caring for patients with the virus. By monitoring and enacting strategies to reduce stress and develop support systems, staff can minimise longer-term impacts.4Whether organisational support and self-care monitoring have achieved better mental health outcomes for healthcare workers is, as yet, unknown.

Research across the globe is underway not only related to the virus itself but also to the mental health consequences of how to get cipro without prescription the pandemic. We do not yet know the extent of the issues or how best to support healthcare providers. In order to better understand the issues and to support nurses at this time, how to get cipro without prescription evidence-based nursing will focus our social media to mental health issues during the month of October.

We will highlight and share relevant resources and information and encourage discussion of the key challenges facing healthcare workers.During October, we will showcase the experiences of four key groups—patients, nurses, students and informal carers and families. Be sure to log into evidence-based nursing each week for the following blogs:October 4 how to get cipro without prescription. Impact of COVID-19 on patient mental health.October 11.

Impact of COVID-19 on nurses’ how to get cipro without prescription mental health and.Twitter Chat on Wednesday October 14 at 20:00 UK time.Oct. 18. Impact of COVID-19 on student nursing.Oct.

25. Impact of COVID-19 on informal carers and families.A PhD is a globally recognised postgraduate degree and typically the highest degree programme awarded by a University, with students usually required to expand the boundaries of knowledge by undertaking original research. The purpose of PhD programmes of study is to nurture, support and facilitate doctoral students to undertake independent research to expected academic and research standards, culminating in a substantial thesis and examined by viva voce.

In this paper—the first of two linked Research Made Simple articles—we explore what the foundations of a high-quality PhD are, and how a Doctoral candidate can develop a study which is successful, original and impactful.Foundations of a ‘good’ PhD studySupervision and supportCentral to the development and completion of a good PhD is the supervisory relationship between the student and supervisor. The supervisor guides the student by directing them to resources and training to ensure continuous learning, provides opportunity to engage with experts in the field, and facilitates the development of critical thinking through questioning and providing constructive criticism.1The support needs of students will be different, so a flexible yet quality assured approach to PhD research training is required. A good supervisory team (usually includes at least two postdoctoral academics) provide experienced guidance and mentorship and will offer students academic support, with regular meetings and timely feedback on written submissions, will assist the student to develop a peer network and help them access research communities relative to their field.

Effective supervision has beneficial outcomes for students, including encouraging a positive work ethic and influencing engagement in a stimulating environment, allowing students to pursue their own ideas with educated encouragement. The quality of the supervisory relationship can impact greatly on the PhD experience and ultimately sets the student on the road to producing excellent Doctoral work.1An environment that promotes personal and professional development is further aided by positive peer interactions. If students feel part of a community and have contact with others also working on doctoral studies, there is the scope for peer compassion and understanding during both challenging and rewarding periods.

Students who access personal and professional support and guidance through mentoring models during their studies are more likely to succeed. These models include one-to-one peer mentoring or activities for example journal discussion or methods learning groups. Often, groups of students naturally come together and give each other support and advice about research process expectations and challenges, and offer friendship, and guidance.2 Given the usefulness of different types of mentoring models, all can create a supportive and collaborative environment within a PhD programme of study, to minimise working in isolation and enable students to achieve their greatest potential.Characteristics of a good study.

Originality and theoretical underpinningA PhD should make an original contribution to knowledge. Originality can be achieved through the study design, the nature or outcomes of the knowledge synthesis, or the implications for research and/or practice.3 Disciplinary variation, however, influences the assessment of originality. For example, originality in science, technology, engineering and mathematics subjects is often inferred if the work is published/publishable, in comparison to intellectual originality in the social sciences.4 Although PhD originality assumes different nuances in different contexts, there is a general acceptance across disciplines that there should be evidence of the following within the thesis:An interplay between old and new—any claims of originality are developed from existing knowledge and practices.There are degrees of originality, relating to more than one aspect of the thesis.Any claims for originality are accompanied by clear articulation of significance.A good PhD should be also underpinned by theoretical and/or conceptual frameworks (that include philosophical and methodological models) that give clarity to the approach, structure and vision of the study.5 These theoretical and conceptual frameworks can explain why the study is pertinent and how the research addresses gaps in the literature.6 Table 1 provides a distinction of what construes theoretical and conceptual frameworks.View this table:Table 1 Characteristics of theoretical and conceptual frameworks7Theoretical/conceptual frameworks must align with the research question/aims, and the student must be able to articulate how conceptual/theoretical framework were chosen.

Key points for consideration include:Are the research questions/aim and objectives well defined?. What theory/theories/concepts are being operationalised?. How are the theories/concepts related?.

Are the ontological and epistemological perspectives clearly conveyed and how do they relate to theories and concepts outlined?. What are the potential benefits and limitations of the theories and concepts outlined?. Are the ways the theories/concepts are outlined and being used original?.

A PhD thesis (and demonstrable in viva) must be able to offer cohesion between the choice of research methods that stems from the conceptual/theoretical framework, the related ontological and epistemological decisions, the theoretical perspective and the chosen methodology (table 2). PhD students must be able to articulate the methodological decisions made and be critical of methods employed to answer their research questions.View this table:Table 2 Relationship between research paradigms, perspectives, methodologies and methods.8 9ConclusionIn summary, we offer considerations of what the foundations of a good PhD should be. We have considered some of the key ingredients of quality PhD supervision, support and research processes and explored how these will contribute to the development of a study that leads to student success and which makes a valuable contribution to the evidence base.

In the next paper, we will look in more detail at the assessment of the PhD through the submission of a thesis and an oral viva..

Cipro and tinnitus

NONE

COVID-19 has evolved rapidly cipro and tinnitus into a pandemic with global keflex vs cipro impacts. However, as the pandemic has cipro and tinnitus developed, it has become increasingly evident that the risks of COVID-19, both in terms of infection rates and particularly of severe complications, are not equal across all members of society. While general risk factors for hospital admission with COVID-19 infection include age, male sex and specific comorbidities (eg, cardiovascular disease, hypertension and diabetes), there is increasing evidence that people identifying with Black, Asian and Minority Ethnic (BAME) groupsi have disproportionately higher risks of being adversely affected by COVID-19 in the UK and the USA. The ethnic disparities include overall numbers of cases, as well as the relative numbers of critical care admissions and deaths.1In the area of mental health, for people from BAME groups, even before the current pandemic there were already significant mental health inequalities.2 These inequalities have cipro and tinnitus been increased by the pandemic in several ways. The constraints of quarantine have made access to traditional face-to-face support from mental health services more difficult in general.

This difficulty will increase pre-existing inequalities where there are challenges to engaging people cipro and tinnitus in care and in providing early access to services. The restrictions may also reduce the flexibility of care offers, given the need for social isolation, limiting non-essential travel and closure of routine clinics. The service impacts are compounded by constraints on the use of non-traditional or alternative routes to care and support.In addition, there is growing evidence of specific mental health consequences from significant COVID-19 infection, with increased rates of not only post-traumatic stress disorder, anxiety and depression, but also specific neuropsychiatric symptoms.3 Given the higher risks of mental illnesses and complex care needs among ethnic minorities and also in deprived inner city cipro and tinnitus areas, COVID-19 seems to deliver a double blow. Physical and mental health vulnerabilities are inextricably linked, especially as a significant proportion of healthcare workers (including in mental health services) in the UK are from BAME groups.Focusing on mental health, there is very little COVID-19-specific guidance on the needs of patients in the BAME group. The risk to staff in general healthcare (including mental healthcare) is a particular concern, and in response, the Royal College of Psychiatrists and NHS England have produced a report on the impact of COVID-19 on BAME staff in mental cipro and tinnitus healthcare settings, with guidance on assessment and management of risk using an associated risk assessment tool for staff.4 5However, there is little formal guidance for the busy clinician in balancing different risks for individual mental health patients and treating appropriately.

Thus, for example, an inpatient clinician may want to know whether a patient who is older, has additional comorbidities and is from an ethnic background, should be started on one antipsychotic medication or another, or whether treatments such as vitamin D prophylaxis or treatment and venous thromboembolism prevention should be started earlier in the context of the COVID-19 pandemic. While syntheses of the existing guidelines are available about COVID-19 and mental health,6 7 there is nothing specific about the does tinnitus from cipro go away healthcare needs of patients from ethnic minorities during the pandemic.To fill this gap, we propose three core actions that may help:Ensure good information and psychoeducation packages are made available to those with English as a second language, and ensure cipro and tinnitus health beliefs and knowledge are based on the best evidence available. Address culturally grounded explanatory models and illness perceptions to allay fears and worry, and ensure timely access to testing and cipro and tinnitus care if needed.Maintain levels of service, flexibility in care packages, and personal relationships with patients and carers from ethnic minority backgrounds in order to continue existing care and to identify changes needed to respond to worsening of mental health.Consider modifications to existing interventions such as psychological therapies and pharmacotherapy. Have a high index of suspicion to take into account emerging physical health problems and the greater risk of serious consequences of COVID-19 in ethnic minority people with pre-existing chronic conditions and vulnerability factors.These actions are based on clinical common sense, but guidance in this area should be provided on the basis of good evidence. There has already been a call for urgent research in the area of COVID-19 and mental health8 and cipro and tinnitus also a clear need for specific research focusing on the post-COVID-19 mental health needs of people from the BAME group.

Research also needs to recognise the diverse range of different people, with different needs and vulnerabilities, who are grouped under the multidimensional term BAME, including people from different generations, first-time migrants, people from Africa, India, the Caribbean and, more recently, migrants from Eastern Europe. Application of a race equality impact assessment to all research questions and methodology has recently been proposed as a first step in this process.2 At this early stage, the guidance for assessing risks of COVID-19 for health cipro and tinnitus professionals is also useful for patients, until more refined decision support and prediction tools are developed. A recent Public Health England report on ethnic minorities and COVID-199 recommends better recording of ethnicity data in health and social care, and goes further to suggest this should also apply to death certificates. Furthermore, the report recommends more participatory and experience-based research to understand causes and consequences of pre-existing multimorbidity and COVID-19 infection, integrated care systems that work well for susceptible and marginalised groups, culturally competent health promotion, prevention and occupational risk assessments, and recovery strategies to mitigate the risks of widening inequalities as we come out of restrictions.Primary data collection will need to cover not only hospital admissions but also cipro and tinnitus data from primary care, linking information on mental health, COVID-19 and ethnicity. We already have research and specific guidance emerging on other risk factors, such as age and gender.

Now we also need to focus on an equally important cipro and tinnitus aspect of vulnerability. As clinicians, we need to balance the relative risks for each of our patients, so that we can act promptly and proactively in response to their individual needs.10 For this, we need evidence-based guidance to ensure we are balancing every risk appropriately and without bias.Footnotei While we have used the term ‘people identifying with BAME groups’, we recognise that this is a multidimensional group and includes vast differences in culture, identity, heritage and histories contained within this abbreviated term..

COVID-19 has evolved how to get cipro without prescription rapidly into a pandemic with global impacts. However, as the pandemic has developed, it has become increasingly evident that the risks of COVID-19, both in terms of infection rates and particularly of severe complications, are not equal across all how to get cipro without prescription members of society. While general risk factors for hospital admission with COVID-19 infection include age, male sex and specific comorbidities (eg, cardiovascular disease, hypertension and diabetes), there is increasing evidence that people identifying with Black, Asian and Minority Ethnic (BAME) groupsi have disproportionately higher risks of being adversely affected by COVID-19 in the UK and the USA. The ethnic disparities include overall numbers of cases, as well as the relative numbers of critical care admissions and how to get cipro without prescription deaths.1In the area of mental health, for people from BAME groups, even before the current pandemic there were already significant mental health inequalities.2 These inequalities have been increased by the pandemic in several ways.

The constraints of quarantine have made access to traditional face-to-face support from mental health services more difficult in general. This difficulty will increase pre-existing inequalities how to get cipro without prescription where there are challenges to engaging people in care and in providing early access to services. The restrictions may also reduce the flexibility of care offers, given the need for social isolation, limiting non-essential travel and closure of routine clinics. The service impacts are compounded by constraints on the use of non-traditional or alternative routes to care and support.In addition, there is growing evidence of specific mental health consequences from significant COVID-19 infection, with increased rates of not only post-traumatic stress disorder, anxiety and depression, how to get cipro without prescription but also specific neuropsychiatric symptoms.3 Given the higher risks of mental illnesses and complex care needs among ethnic minorities and also in deprived inner city areas, COVID-19 seems to deliver a double blow.

Physical and mental health vulnerabilities are inextricably linked, especially as a significant proportion of healthcare workers (including in mental health services) in the UK are from BAME groups.Focusing on mental health, there is very little COVID-19-specific guidance on the needs of patients in the BAME group. The risk to staff in general healthcare (including mental healthcare) is a particular concern, and in response, the how to get cipro without prescription Royal College of Psychiatrists and NHS England have produced a report on the impact of COVID-19 on BAME staff in mental healthcare settings, with guidance on assessment and management of risk using an associated risk assessment tool for staff.4 5However, there is little formal guidance for the busy clinician in balancing different risks for individual mental health patients and treating appropriately. Thus, for example, an inpatient clinician may want to know whether a patient who is older, has additional comorbidities and is from an ethnic background, should be started on one antipsychotic medication or another, or whether treatments such as vitamin D prophylaxis or treatment and venous thromboembolism prevention should be started earlier in the context of the COVID-19 pandemic. While syntheses of the existing guidelines are available about COVID-19 and mental health,6 7 there is nothing specific about the healthcare needs of patients from how to get cipro without prescription ethnic minorities during the pandemic.To fill this gap, we propose three core actions that may help:Ensure good information and psychoeducation packages are made available to those with English as a second language, and ensure health beliefs and knowledge are based on the best evidence available.

Address culturally grounded explanatory models and illness perceptions to allay fears and worry, and ensure timely access to testing and care if needed.Maintain levels of service, flexibility in care packages, and personal relationships with patients and carers how to get cipro without prescription from ethnic minority backgrounds in order to continue existing care and to identify changes needed to respond to worsening of mental health.Consider modifications to existing interventions such as psychological therapies and pharmacotherapy. Have a high index of suspicion to take into account emerging physical health problems and the greater risk of serious consequences of COVID-19 in ethnic minority people with pre-existing chronic conditions and vulnerability factors.These actions are based on clinical common sense, but guidance in this area should be provided on the basis of good evidence. There has already been a call for urgent research in the area of COVID-19 and mental health8 and also a clear need for specific research focusing how to get cipro without prescription on the post-COVID-19 mental health needs of people from the BAME group. Research also needs to recognise the diverse range of different people, with different needs and vulnerabilities, who are grouped under the multidimensional term BAME, including people from different generations, first-time migrants, people from Africa, India, the Caribbean and, more recently, migrants from Eastern Europe.

Application of a race equality impact assessment to all research questions how to get cipro without prescription and methodology has recently been proposed as a first step in this process.2 At this early stage, the guidance for assessing risks of COVID-19 for health professionals is also useful for patients, until more refined decision support and prediction tools are developed. A recent Public Health England report on ethnic minorities and COVID-199 recommends better recording of ethnicity data in health and social care, and goes further to suggest this should also apply to death certificates. Furthermore, the report recommends more participatory and experience-based research to understand causes and consequences of pre-existing multimorbidity and COVID-19 infection, integrated care systems that work well for susceptible and marginalised how to get cipro without prescription groups, culturally competent health promotion, prevention and occupational risk assessments, and recovery strategies to mitigate the risks of widening inequalities as we come out of restrictions.Primary data collection will need to cover not only hospital admissions but also data from primary care, linking information on mental health, COVID-19 and ethnicity. We already have research and specific guidance emerging on other risk factors, such as age and gender.

Now we also need to focus on an equally important aspect how to get cipro without prescription of vulnerability. As clinicians, we need to balance the relative risks for each of our patients, so that we can act promptly and proactively in response to their individual needs.10 For this, we need evidence-based guidance to ensure we are balancing every risk appropriately and without bias.Footnotei While we have used the term ‘people identifying with BAME groups’, we recognise that this is a multidimensional group and includes vast differences in culture, identity, heritage and histories contained within this abbreviated term..

Cipro xr

NONE

NCHS Data Brief No cipro xr. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with an increased risk for chronic cipro xr conditions such as cardiovascular disease (1) and diabetes (2).

Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition. Menopause is “the permanent cessation of menstruation that occurs after the cipro xr loss of ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status.

The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis, 74.2% cipro xr of women are premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal. Keywords.

Insufficient sleep, cipro xr menopause, National Health Interview Survey Perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 cipro xr. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, 2015image icon1Significant quadratic trend by menopausal status (p < cipro xr.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no cipro xr longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure cipro xr 1pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in cipro xr the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 cipro xr. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend cipro xr by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were cipro xr perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data cipro xr table for Figure 2pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times or more in the past week (26.7%) cipro xr (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 cipro xr. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear cipro xr trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago cipro xr or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for cipro xr Figure 3pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage cipro xr of women in this age group who did not wake up feeling well rested 4 days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 cipro xr. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <.

0.05).NOTES. Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less.

Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE. NCHS, National Health Interview Survey, 2015.

SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories.

Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5). Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status.

A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?. €.

2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries.

Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less. Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?.

€Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?. €Trouble falling asleep.

Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone.

Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS. For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States.

The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS. Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option.

Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454.

2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB. Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50.

2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No. 141.

Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N.

Perimenopause. From research to practice. J Women’s Health (Larchmt) 25(4):332–9.

2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult. A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society.

J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International.

SUDAAN (Release 11.0.0) [computer software]. 2012. Suggested citationVahratian A.

Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286. Hyattsville, MD.

National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J.

Blumberg, Ph.D., Associate Director for Science.

NCHS Data how to get cipro without prescription Brief No you can check here. 286, September 2017PDF Versionpdf icon (374 KB)Anjel Vahratian, Ph.D.Key findingsData from the National Health Interview Survey, 2015Among those aged 40–59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period.Postmenopausal women aged 40–59 were more likely than premenopausal women aged 40–59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week.Postmenopausal women aged 40–59 (55.1%) were more likely than premenopausal women aged 40–59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.Sleep duration and quality are important contributors to health and wellness. Insufficient sleep is associated with an increased risk for chronic conditions how to get cipro without prescription such as cardiovascular disease (1) and diabetes (2). Women may be particularly vulnerable to sleep problems during times of reproductive hormonal change, such as after the menopausal transition.

Menopause is “the how to get cipro without prescription permanent cessation of menstruation that occurs after the loss of ovarian activity” (3). This data brief describes sleep duration and sleep quality among nonpregnant women aged 40–59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this how to get cipro without prescription analysis, 74.2% of women are premenopausal, 3.7% are perimenopausal, and 22.1% are postmenopausal.

Keywords. Insufficient sleep, menopause, National Health Interview Survey Perimenopausal women were more likely than how to get cipro without prescription premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.More than one in three nonpregnant women aged 40–59 slept less than 7 hours, on average, in a 24-hour period (35.1%) (Figure 1). Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period (56.0%), compared with 32.5% of premenopausal and 40.5% of postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Figure 1 how to get cipro without prescription. Percentage of nonpregnant women aged 40–59 who slept less than 7 hours, on average, in a 24-hour period, by menopausal status. United States, how to get cipro without prescription 2015image icon1Significant quadratic trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no how to get cipro without prescription longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure how to get cipro without prescription 1pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had how to get cipro without prescription trouble falling asleep four times or more in the past week varied by menopausal status.Nearly one in five nonpregnant women aged 40–59 had trouble falling asleep four times or more in the past week (19.4%) (Figure 2). The percentage of women in this age group who had trouble falling asleep four times or more in the past week increased from 16.8% among premenopausal women to 24.7% among perimenopausal and 27.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble falling asleep four times or more in the past week.

Figure 2 how to get cipro without prescription. Percentage of nonpregnant women aged 40–59 who had trouble falling asleep four times or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal how to get cipro without prescription status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were how to get cipro without prescription perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for how to get cipro without prescription Figure 2pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week varied by menopausal status.More than one in four nonpregnant women aged 40–59 had trouble staying asleep four times how to get cipro without prescription or more in the past week (26.7%) (Figure 3). The percentage of women aged 40–59 who had trouble staying asleep four times or more in the past week increased from 23.7% among premenopausal, to 30.8% among perimenopausal, and to 35.9% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to have trouble staying asleep four times or more in the past week.

Figure 3 how to get cipro without prescription. Percentage of nonpregnant women aged 40–59 who had trouble staying asleep four times or more in the past week, by menopausal status. United States, how to get cipro without prescription 2015image icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago how to get cipro without prescription or less. Women were premenopausal if they still had a menstrual cycle. Access data table how to get cipro without prescription for Figure 3pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. The percentage of women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week varied by menopausal status.Nearly one in two nonpregnant women aged 40–59 did not wake up feeling well rested 4 days or more in the past week (48.9%) (Figure 4). The percentage of women in this age group who did not wake up feeling well rested 4 how to get cipro without prescription days or more in the past week increased from 47.0% among premenopausal women to 49.9% among perimenopausal and 55.1% among postmenopausal women. Postmenopausal women were significantly more likely than premenopausal women to not wake up feeling well rested 4 days or more in the past week.

Figure 4 how to get cipro without prescription. Percentage of nonpregnant women aged 40–59 who did not wake up feeling well rested 4 days or more in the past week, by menopausal status. United States, 2015image icon1Significant linear trend by menopausal status (p <. 0.05).NOTES.

Women were postmenopausal if they had gone without a menstrual cycle for more than 1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was 1 year ago or less. Women were premenopausal if they still had a menstrual cycle. Access data table for Figure 4pdf icon.SOURCE.

NCHS, National Health Interview Survey, 2015. SummaryThis report describes sleep duration and sleep quality among U.S. Nonpregnant women aged 40–59 by menopausal status. Perimenopausal women were most likely to sleep less than 7 hours, on average, in a 24-hour period compared with premenopausal and postmenopausal women.

In contrast, postmenopausal women were most likely to have poor-quality sleep. A greater percentage of postmenopausal women had frequent trouble falling asleep, staying asleep, and not waking well rested compared with premenopausal women. The percentage of perimenopausal women with poor-quality sleep was between the percentages for the other two groups in all three categories. Sleep duration changes with advancing age (4), but sleep duration and quality are also influenced by concurrent changes in women’s reproductive hormone levels (5).

Because sleep is critical for optimal health and well-being (6), the findings in this report highlight areas for further research and targeted health promotion. DefinitionsMenopausal status. A three-level categorical variable was created from a series of questions that asked women. 1) “How old were you when your periods or menstrual cycles started?.

€ cipro lawyer. 2) “Do you still have periods or menstrual cycles?. €. 3) “When did you have your last period or menstrual cycle?.

€. And 4) “Have you ever had both ovaries removed, either as part of a hysterectomy or as one or more separate surgeries?. € Women were postmenopausal if they a) had gone without a menstrual cycle for more than 1 year or b) were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they a) no longer had a menstrual cycle and b) their last menstrual cycle was 1 year ago or less.

Premenopausal women still had a menstrual cycle.Not waking feeling well rested. Determined by respondents who answered 3 days or less on the questionnaire item asking, “In the past week, on how many days did you wake up feeling well rested?. €Short sleep duration. Determined by respondents who answered 6 hours or less on the questionnaire item asking, “On average, how many hours of sleep do you get in a 24-hour period?.

€Trouble falling asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble falling asleep?. €Trouble staying asleep. Determined by respondents who answered four times or more on the questionnaire item asking, “In the past week, how many times did you have trouble staying asleep?.

€ Data source and methodsData from the 2015 National Health Interview Survey (NHIS) were used for this analysis. NHIS is a multipurpose health survey conducted continuously throughout the year by the National Center for Health Statistics. Interviews are conducted in person in respondents’ homes, but follow-ups to complete interviews may be conducted over the telephone. Data for this analysis came from the Sample Adult core and cancer supplement sections of the 2015 NHIS.

For more information about NHIS, including the questionnaire, visit the NHIS website.All analyses used weights to produce national estimates. Estimates on sleep duration and quality in this report are nationally representative of the civilian, noninstitutionalized nonpregnant female population aged 40–59 living in households across the United States. The sample design is described in more detail elsewhere (7). Point estimates and their estimated variances were calculated using SUDAAN software (8) to account for the complex sample design of NHIS.

Linear and quadratic trend tests of the estimated proportions across menopausal status were tested in SUDAAN via PROC DESCRIPT using the POLY option. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. About the authorAnjel Vahratian is with the National Center for Health Statistics, Division of Health Interview Statistics. The author gratefully acknowledges the assistance of Lindsey Black in the preparation of this report.

ReferencesFord ES. Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults. J Am Heart Assoc 3(6):e001454. 2014.Ford ES, Wheaton AG, Chapman DP, Li C, Perry GS, Croft JB.

Associations between self-reported sleep duration and sleeping disorder with concentrations of fasting and 2-h glucose, insulin, and glycosylated hemoglobin among adults without diagnosed diabetes. J Diabetes 6(4):338–50. 2014.American College of Obstetrics and Gynecology. ACOG Practice Bulletin No.

141. Management of menopausal symptoms. Obstet Gynecol 123(1):202–16. 2014.Black LI, Nugent CN, Adams PF.

Tables of adult health behaviors, sleep. National Health Interview Survey, 2011–2014pdf icon. 2016.Santoro N. Perimenopause.

From research to practice. J Women’s Health (Larchmt) 25(4):332–9. 2016.Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended amount of sleep for a healthy adult.

A joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. J Clin Sleep Med 11(6):591–2. 2015.Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the National Health Interview Survey, 2006–2015.

National Center for Health Statistics. Vital Health Stat 2(165). 2014.RTI International. SUDAAN (Release 11.0.0) [computer software].

2012. Suggested citationVahratian A. Sleep duration and quality among women aged 40–59, by menopausal status. NCHS data brief, no 286.

Hyattsville, MD. National Center for Health Statistics. 2017.Copyright informationAll material appearing in this report is in the public domain and may be reproduced or copied without permission. Citation as to source, however, is appreciated.National Center for Health StatisticsCharles J.

Rothwell, M.S., M.B.A., DirectorJennifer H. Madans, Ph.D., Associate Director for ScienceDivision of Health Interview StatisticsMarcie L. Cynamon, DirectorStephen J. Blumberg, Ph.D., Associate Director for Science.